Utilisation of diverse healthcare providers: Virtual health service engagement and geographic barriers among Aboriginal and Torres Strait Islander adults with chronic disease

Background Virtual Health Services (VHS) may improve healthcare access for rural Aboriginal and Torres Strait Islander people, but little is known about whether active engagement is associated with more diverse providers or reduced geographic barriers to primary care. This study examined whether active VHS engagement was associated with provider diversity and moderated geographic distance effects on primary care access. Methods This cross-sectional analysis included 74 Aboriginal and Torres Strait Islander adults enrolled in the Goondir Health Services VHS program in rural Queensland. VHS status (active versus inactive in the past 2 weeks) was the primary exposure, with outcomes being provider diversity across 27 types and visit frequency to 12 services over 12 months. Negative binomial regression, adjusted for sociodemographic, lifestyle and health factors including chronic disease burden examined VHS associations with provider diversity, and interaction terms tested whether active engagement moderated distance effects on Aboriginal Medical Service (AMS) visits. Results Of 74 participants, 47 (63.5%) were active VHS users. After covariate adjustment including chronic disease burden, active users utilised significantly more diverse providers, including specialists (IRR=1.78, 95% CI: 1.12–2.82), allied health professionals (IRR=1.60, 95% CI: 1.04–2.48) and overall providers (IRR=1.44, 95% CI: 1.13–1.83). Distance was associated with AMS visit frequency among inactive but not active users (interaction IRR=0.24, 95% CI: 0.07–0.85), suggesting VHS may moderate distance barriers to primary care. Conclusions Active VHS engagement was independently associated with greater use of diverse providers, potentially offsetting geographic barriers to primary care, warranting larger studies.